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Radiography >> Radiologic Technologist >> Technologists, Technicians & Other Technical Service Providers

Registrant NPI Number: 1396110839

Individual Registrant:
Gender: M
Sole Proprietor

Location and contact information for practice:
749 CR 482N  LAKE PANASOFFKEE, FL 33538-6007 US
Tel: 352-793-3877  Fax: --

Contact information for business:
749 CR 482N  LAKE PANASOFFKEE, FL 33538-6007 US
Tel: 352-793-3877  Fax: --

Registration Information:
NPI: 1396110839
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N2471C3402XTechnologists, Technicians & Other Technical Service Providers
Radiologic Technologist
Y2471M1202XTechnologists, Technicians & Other Technical Service Providers
Radiologic Technologist

Legacy codes, insurance codes and state license numbers:



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